The Calcium conundrum
For years Calcium has been promoted as the big preventer of developing Osteoporosis. Dairy companies spend millions on campaigns to tell us how much we need their products to keep our bones and teeth strong and we want to believe that because it’s an ‘easy’ solution to a terrible problem. But, hang on, if we’re drinking milk and eating dairy products such as cheese and yoghurts daily, how come that Osteoporosis is so prevalent in the western world?
In the UK, NHS data shows that Osteoporosis affects over 3 million people and more than 500.000 people receive hospital treatment for fragility fractures (bones that break after falling from standing height or less) every years as a result of Osteoporosis.
So something isn’t adding up, but what is it?
I think the best starting point to investigate this is to recognise that bone loss and Osteoporosis during and after menopause, is a complex, multifaceted condition and requires many different approaches, even for the same individual. There is no one ‘magic cure’ unfortunately, but that just makes it so much more challenging and interesting.
In this post we’re going to look at calcium and its role in bone development and how it is affected by menopause and ageing.
As we reach our forties and beyond, for some reason, the gut’s ability to absorb the calcium we eat becomes less efficient. The body needs to keep a delicate intestinal fluid and blood calcium levels, and it the body isn’t able to absorb enough from the food we eat, the body) starts to draw Calcium from our bones via the Osteoclast cells (discussed in a previous blog) , and that causes the bones to lose some of its strength. This comes on top of the drop in oestrogen that causes the Osteoclasts to get even more effective and eat up more bone…oh, dear, this being a woman is really starting to sound like a bad idea!
But this isn’t the whole story because unfortunately (or fortunately) depending how you look at it, the calcium gut absorption sluggishness isn’t the only thing we’re dealing with. Other factors also cause Calcium to be drawn from our bones to maintain acid/alkaline balance in our blood and intestinal fluids, and these are the factors that we can definitely do something about.
Factors that also cause Calcium to be drawn from your bones:
· Smoking. The mechanisms of the exact way in which this happens is still not fully understood.
· Stress. Increased levels of the stress hormone Cortisol, causes Calcium to leak from our bones.
· High meat, salt and processed food intake. This is probably due to the body trying to maintain a delicate acid/alkaline balance. There is some suggestion that high consumption of dairy products is counter-productive as it causes the blood to become more acid, and therefor Calcium will be drawn from the bones.
· Lack of adequate Vitamin D. Vitamin D, which interestingly is a hormone or rather a pro-hormone, is needed for the body to be able to absorb and utilise Calcium in the gut. I will be discussing Vitamin D in more detail in blogpost coming soon. We get Vitamin D from exposure to the sun and foods, and the body has the ability to make Vitamin D.
These are all factors we can work on improving by stopping smoking, finding ways to reduce our stress, go outside to (safely) absorb sunlight and by eating the foods that are known to contain well absorbable Calcium and Vitamin D.
So what are the foods we should include in our diet:
· I’m never going to tell anyone not to eat dairy, but I will tell people to hedge their bets and try to get their Calcium from many different sources and not just dairy. Many people are Vegetarian and Vegan and they achieve just as good Calcium absorption (possibly even better) than a dairy eating person, as they will be getting their Calcium from many different foods. If you like to keep dairy in your diet, go for as good quality organic products as you can afford, as the soil the cows have been grazing on needs to be pesticide and chemical free and of high quality to reduce the chance of us absorbing these into our bodies.
· Milk alternatives such as almond milk, oat milk and soya milk is fortified with Calcium so a good choice too
· Fish, but not all fish is equal. Tinned sardines and marcel (with the bones) is high is Calcium and fatty fish such as salmon, marcel and tune is high in Vitamin D, but choose responsibly farmed/fished varieties.
· Leafy greens, Kale, collard greens, broccoli, Chinese cabbage, okra, Brussel sprouts but not spinach.
· Legumes, especially black eyed peas and Canelli beans.
· Sesame seeds as in Tahini.
· Seaweed, such as Nori.
· Shitake mushrooms
· Eggs, a good source of Vitamin D.
· Calcium and Vitamin D supplements if you feel you can’t get enough from your foods. The recommended dose for women approaching the menopause and beyond is 1000-1500 milligrams of Calcium a day. Too much Calcium and the wrong form of Calcium (I will discuss this in more detail in another blog) from supplements can cause problems such as gallstones, so it’s not something where ‘the more the better’-absolutely not!
· The same applies to Vitamin D, because as I mentioned earlier, vitamin D isn’t really a vitamin but a hormone, and too much of it or the wrong type can cause problems and toxicity. The NHS recommends that people in the UK (not getting a lot of sunlight between October and March) should take at least 10 Micrograms ( 400 iu) of Vitamin D a day. My recommendation is to take Vitamin D3, the form best absorbed and utilised by the body. I suggest you use a reputable supplement company and follow the recommendation on the package.
There's a lot to think about here, but the ultimate take-away message is that there is alot we can do to support our bones during the menopause and beyond but it takes some thought, dedication and more than anything- self-love- but you are so absolutely worth it!